Increased positive thought disorder with illness duration in patients with schizophrenia

Abstract

It is unclear whether the severity of positive formal thought disorder, a core clinical feature of schizophrenia, is stable or worsening through the chronic course of the illness. The neurocognitive basis for positive thought disorder also remains unclear. The aim of the present paper was to examine the relationship between thought disorder as measured by the Thought Disorder Index (TDI) and duration of illness and neuropsychological indices in 79 patients with schizophrenia.TDI scores increased in proportion to illness duration. TDI scores were not associated with verbal memory or executive functioning. These results indicate an ongoing worsening of positive thought disorder through the course of illness in schizophrenia.

The impact of thought disorder on therapeutic alliance and personal recovery in schizophrenia and schizoaffective disorder: An exploratory study

“…Thought disorder predicted psychosis transition of young people at-risk mental state (Katsura et al, 2014) and was also found among relatives of patients with schizophrenia (Manschreck et al, 2012). It is moderately stable (trait marker; Wilcox et al, 2012) but becomes exacerbated during the acute episode, tends to increase in severity with illness duration (Maeda et al, 2007), and may also persist during antipsychotic treatment (Remberk et al, 2012). Thought disorder can be as disabling as the other symptoms of schizophrenia, limiting social and occupational functioning (Tirupati et al, 2004) as well as wellbeing and life satisfaction (Sigaudo et al, 2014;Tan et al, 2014).…”

Putting the person first : an examination of thought disorder and personality heterogeneity in schizophrenia.

“…For example, the relationships between thought disorder severity and poor general prognosis were found across diagnostic lines Harrow, Silverstein, &Marengo, 1983;Marengo & Harrow, 1987;Racenstein et al, 1999). The other functional relationships, including poorer work functioning and increased psychopathology, were also found regardless of diagnosis Harrow, Silverstein, &Marengo, 1983;Maeda et al, 2007, Marengo & Harrow, 1997Racenstein et al, 1999).…”

“…Specifically, high levels of thought disorder persisting beyond the acute stages of illness have consistently been associated with a particularly negative clinical course and poorer functional prognosis (Andreasen & Grove, 1986;Bowie & Harvey, 2008;Harrow, Silverstein, & Marengo, 1983;Harvey et al, 1990;Marengo & Harrow, 1987;Marengo, Harrow, M., Lanin-Kettering, &Wilson, 1986). Longitudinal studies have reported significant relationships between higher levels of thought disorder at baseline and higher rates of rehospitalization (Harrow, Marengo, & McDonald, 1986;) and duration of illness (Maeda et al, 2007). Research has also suggested a strong positive relationship between thought disorder and delusional severity, across diagnostic lines (Harrow, Silverstein, and Marengo 1983;Harrow, Marengo, & McDonald 1986;Marengo & Harrow, 1997).…”

“…However, thought disorder, particularly the more chronic trait-like forms are independent of psychosis (Marengo & Harrow, 1985;Marengo & Harrow, 1997). Finally, negative relationships have been reported between thought disorder and longitudinal occupational functioning Harrow, Silverstein, &Marengo, 1983;Maeda et al, 2007, Marengo &Harrow, 1997Racenstein, Penn, Harrow, & Schleser, 1999) as well as social areas of functioning (Bowie & Harvey, 2008;Racenstein et al, 1999).…”

Exploring a multifactorial, clinical model of thought disorder : application of a dimensional, transdiagnostic approach.

“…Thought disorder severity has been shown to increase as a function of illness duration (Maeda et al, 2007;Spohn et al, 1986) as well as number of hospitalizations (Marengo & Harrow, 1997;Spohn et al, 1986). However, inconsistent evidence also exists.…”